Abstract: The Office of Research on Women's Health (orwh) at the National Institutes of Health (nth) was created in 1990 to carry out three major mandates: (1)




НазваниеAbstract: The Office of Research on Women's Health (orwh) at the National Institutes of Health (nth) was created in 1990 to carry out three major mandates: (1)
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References

Pinn, V.W. (1994), The Role of the Nihs Office-Of-Research-On-Womens-Health. Academic Medicine, 69 (9), 698-702.

Abstract: The Office of Research on Women's Health (ORWH) at the National Institutes of Health (NTH) was created in 1990 to carry out three major mandates: (1) to strengthen, develop, and increase research into diseases, disorders, and conditions that are unique to, more prevalent among, or more serious in women, or for which there are different risk factors for women than for men; (2) to ensure that women are appropriately represented in biomedical and biobehavioral research studies, especially clinical trials, that are supported by the NIH; and (3) to direct initiatives to increase the number of women in biomedical careers. One of the ORWH's first accomplishments was a 1992 report that serves as a basis for the ORWH's research agenda; its recommendations focus on scientific issues affecting women's health from birth to old age. To implement these recommendations, the ORWH does not fund studies directly but instead provides funds through NIH institutes and centers to augment new research initiatives, to expand ongoing studies to address high-priority areas concerning women's health (14 of which were identified for special consideration in FY 93), and to increase the participation of women in clinical studies. In addition, the ORWH is playing a key advisory role in the NIH's Women's Health Initiative, a long-term study of over 100,000 women to examine the major causes of death, disability, and frailty-heart disease and stroke, breast and colorectal cancers, and osteoporosis-in older women of all races and from all socioeconomic strata. Also, as part of the NIH's overall effort to include more women and minorities in clinical research, the office formed a task force to address concerns about the recruitment and retention of women in clinical studies and is disseminating information to help investigators to recruit and retain more women as research subjects. The office is also involved in the development of MH guidelines on the participation of women and minorities in clinical research, to be implemented in FY 95. A major goal of the ORWH and the NIH is to promote greater participation of women in biomed-ical research careers; the steps being taken to identify barriers and to increase opportunities are explained

Keywords: SEP/WOMEN

Fourie, P.R., Coetzee, A.R., Bolliger, C.T. and Lombard, C.J. (1994), Pulmonary-Artery Compliance - Its Role in Right-Ventricular Function During Acute Pulmonary-Hypertension. Acp-Applied Cardiopulmonary Pathophysiology, 5 (2), 101-110.

Abstract: With the advent of acute pulmonary hypertension induced by the injection of glass microspheres into the pulmonary bed of the open-chested pig model, the cardiac output and stroke volume decrease while myocardial contractility and arterial oxygen content remains normal. By analysing the differential reaction of the heart to changes in vascular bed resistance (Rp) versus arterial compliance (C) it can be shown, that with the advent of acute pulmonary hypertension, the dramatic decrease in compliance increases the sensitivity of the right ventricle to changes in Rp and the stroke volume changes accordingly

Keywords: ACUTE PULMONARY HYPERTENSION/AFRICA/BLOOD-FLOW/CHARACTERISTIC IMPEDANCE/NETHERLANDS/PULMONARY ARTERY COMPLIANCE/RESPIRATORY-FAILURE/VOLUME

Boyd, O., Murdoch, L.J., Mackay, C.J., Bennett, E.D. and Grounds, R.M. (1994), The Cardiovascular Changes Associated with Equipotent Anesthesia with Either Propofol Or Isoflurane - Particular Emphasis on Right-Ventricular Function. Acta Anaesthesiologica Scandinavica, 38 (4), 357-362.

Abstract: The differences in effects of anaesthetic agents on right ventricular function have not been studied. We have developed a cross-over study design to compare the effects of propofol and isoflurane on cardiac and specifically right ventricular function. Ten patients were anaesthetised with equivalent MAC of isoflurane to MIR of propofol. After measurements had been taken on the randomly assigned first agent the patients were crossed over to the other agent and measurements,were repeated. Cardiac function was assessed using a pulmonary artery catheter with a fast response thermistor. There were no differences in heart rate or blood pressure between the two agents suggesting that equivalent anaesthetic doses had been given. There were significantly (P < 0.05) higher cardiac output (4.0 to 4.5 l.min(-1)), right ventricular ejection fraction (35.1 to 39.4%), stroke volume (35.4 to 39.6 ml) and right ventricular end-diastolic volume index (102 to 110 ml.m(2-1)) with propofor compared to isoflurane. We conclude that propofol results in improved right ventricular performance compared to isoflurane. We have also shown that anaesthetic agents can be compared using a cross-over study design, and have demonstrated that MAC of isoflurane and MIR of propofol can be directly compared. We suggest that propofol may be a more suitable agent than isoflurane for anaesthesia in patients who may already have impaired right ventricular function and in whom maintaining high cardiac output may be beneficial

Keywords: ANESTHESIA/CARDIAC OUTPUT/CLINICAL-TRIAL/COPENHAGEN/DENMARK/GENERAL/HUMAN/INHALATION/INTRAVENOUS/ISOFLURANE/MINIMUM ALVEOLAR CONCENTRATION (MAC)/MINIMUM INFUSION RATE (MIR)/PROPOFOL/RIGHT VENTRICULAR FUNCTION/SURGERY/VASCULAR SURGERY

Hohner, P. and Reiz, S. (1994), Nitrous-Oxide and the Cardiovascular-System. Acta Anaesthesiologica Scandinavica, 38 (8), 763-766

Keywords: ANESTHESIA/CONTRACTILE FUNCTION/COPENHAGEN/CORONARY-ARTERY DISEASE/DENMARK/FENTANYL ANESTHESIA/HUMANS/INDUCE MYOCARDIAL ISCHEMIA/ISCHEMIC HEART-DISEASE/ISOFLURANE- ANESTHETIZED DOGS/PERFORMANCE/RECRUITABLE STROKE WORK/SURGERY

Vanderlinden, P., Wathieu, M., Gilbart, E., Engelman, E., Wautrecht, J.C., Lenaers, A. and Vincent, J.L. (1994), Cardiovascular Effects of Moderate Normovolemic Hemodilution During Enflurane-Nitrous Oxide Anesthesia in Man. Acta Anaesthesiologica Scandinavica, 38 (5), 490-498.

Abstract: The cardiovascular effects of mild normovolaemic haemodilution during enflurane-nitrous oxide anaesthesia were studied in 20 patients with normal cardiac function before, during and after total hip replacement. After induction of anaesthesia, patients were randomly allocated to one control group (C), or one haemodiluted group (H) where Hct was decreased to 30% by replacement of blood volume by an identical volume of hydroxyethyl starch 200/0.5. Each patient was monitored with a pulmonary artery catheter allowing the measurement of right ventricular ejection fraction. During haemodilution, stroke index and right ventricular end-diastolic volume index increased from 33.1 +/- 7.9 to 39.3 +/- 7.1 ml M(-2) and from 73.8 +/- 20.3 to 94.9 +/- 18.5 ml.M(-2) respectively (mean +/- s.d., both P< 0.05). However, heart rate decreased so that cardiac index did not change. O-2 delivery decreased significantly (from 389 +/- 70 to 311 +/- 63 ml.min(-1).m(-2) P< 0.05), but was not different to the control group. O-2 consumption was maintained by an increase in O-2 extraction. During the surgical procedure, cardiac index was higher in the haemodiluted group than in the control group, so that O-2 delivery was similar in the two groups. O-2 consumption tended to be greater in the haemodiluted group. In patients with normal cardiac function, enflurane-nitrous oxide anaesthesia could alter the normal physiologic response to mild normovolaemic haemodilution

Keywords: ANEMIA/ANESTHESIA/ANESTHETIC TECHNIQUES-GENERAL/BLOOD-HEMODILUTION/COLLOIDS- HYDROXYETHYLSTARCH/COPENHAGEN/DENMARK/DOGS/ETOMIDATE/EXPANDERS/HEMODILUTION/HEMODYNAMICS-OXYGEN TRANSPORT/stroke/TRANSFUSION/VENTRICULAR EJECTION FRACTION

Raner, C., Biber, B., Lundberg, J., Martner, J. and Winso, O. (1994), Cardiovascular Depression by Isoflurane and Concomitant Thoracic Epidural-Anesthesia Is Reversed by Dopamine. Acta Anaesthesiologica Scandinavica, 38 (2), 136-143.

Abstract: Interactive effects between exogenous dopamine (DA) and isoflurane (I) combined with thoracic epidural blockade (TEA) were studied in dogs during chloralose anesthesia. The I-TEA intervention per se decreased heart rate (HR; 28%), mean arterial pressure (MAP; 63%), cardiac output (CO; 54%), left ventricular dP/ dt (LVdP/dt; 75%) and LVdP/dt/systolic arterial pressure (SAP; 42%). Prior to tile I-IEA intervention, dopamine increased MAP, CO, LVdP/dt, LVdP/dt/SAP and stroke volume (SV) already at the dose 10 mu g kg(-1) min(-1) and, additionally, increased mean pulmonary artery pressure (MPAP) at the dose 20 mu g.kg(-1).min(-1). During the I-TEA intervention, the DA- induced increases in MAP and systemic vascular resistance (SVR) were significantly higher than prior to I-TEA, as indicated by significant ANOVA interactive effects. At the dose 10 mu g.kg(- 1).min(-1), DA restored MAP, CO, LVdP/dt, LVdP/dt/SAP and SV to levels found before the I-TEA intervention, while HR was restored first at the dose 20 mu g.kg(-1).min(-1). At the dose 20 mu g.kg(-1).min(-1), DX also increased MAP (39%), LVdP/dt (119%), LVdP/dt/SAP (73%), SVR (28%) and MPAP (70%) above levels prior to I-TEA. To conclude, exogenous dopamine effectively and dose-dependently counters cardiovascular depression induced by the anesthetic technique of combining I and TEA. The presser and systemic vasoconstrictor actions of dopamine are potentiated by conjoint administration of I and TEA

Keywords: ANALGESIA/BLOCK/CATECHOLAMINE/CATECHOLAMINES/CHLORALOSE/CO/COPENHAGEN/DENMARK/DOG/DOPAMINE/HEMODYNAMICS/ISOFLURANE/METABOLISM/NOREPINEPHRINE/OXYGEN UPTAKE/OXYGEN-CONSUMPTION/RESPONSES/SPINAL HYPOTENSION/SURGERY/THORACIC EPIDURAL ANESTHESIA

Suzuki, Y., Kashihara, H., Takenaka, K., Kawakubo, K., Makita, Y., Goto, S., Ikawa, S. and Gunji, A. (1994), Effects of Daily Mild Supine Exercise on Physical Performance After 20 Days Bed Rest in Young Persons. Acta Astronautica, 33 101-111.

Abstract: To investgate the effects of daily mild supine exercise on physical performance capacity identified as maximal oxygen uptake rate (VO2max) after 20 days bed-rest. 3 male students performed a supine pedaling at 40 % intensity Of VO2max for one hour every day, while 6 male and 5 female students were control. Before and after the bed-rest. muscle mass and strength of exercising leg and cardio-vascular responses during -40 mmHg lower body negative pressure (LBNP) and moderate upright cycling exercise were measured. Despite the exercise program VO2max was similarly decreased to the control subjects after the bed-rest. The delta VO2max was correlated to delta % left ventricular fractional shortening during LBNP. and also % delta VO2max to % delta stroke volume of the moderate exercise (both p<0.05). The exercise programme should be too weak to maintain cardiovascular functions and thus to present the decrease in VO2max against pro-longed bed-rest as well as weightlessness stress

Keywords: ENGLAND/LEFT VENTRICULAR FRACTIONAL SHORTENING/MAXIMAL OXYGEN UPTAKE RATE/MAXIMUM VOLUNTARY CONTRACTION/MILD SUPINE EXERCISE/MUSCULAR MASS/stroke/STROKE VOLUME

Breek, J.C., Peters, N., Dewitte, R. and Bleyn, J. (1994), Carotid Surgery Under Locoregional Anesthesia Description of Technique and Results of Our 1St 100 Consecutive Operations. Acta Chirurgica Belgica , (5), 274-276.

Abstract: In a 28-month-period 100 consecutive carotid operations were performed on 91 patients under locoregional anaesthesia. The indications were 37 TIAs, 16 recovered strokes, 12 cases presenting with amaurosis fugax, eight with vertigo and 27 patients with severe but still asymptomatic stenosis. In 20 cases a shunt had to be used. Twice a transient neurological syndrome developed, two strokes occurred. One stroke patient died in the postoperative course. Carotid surgery under locoregional anaesthesia seems to be a safe method with advantages for the patient and the surgeon

Keywords: ANESTHESIA/BELGIUM/CAROTID ARTERY DISEASES/LOCAL/VASCULAR SURGERY

Romner, B., Sjoholm, H. and Brandt, L. (1994), Transcranial Doppler Sonography, Angiography and Spect Measurements in Traumatic Carotid-Artery Dissection. Acta Neurochirurgica, 126 (2-4), 185-191.

Abstract: In two young patients with traumatic internal carotid artery dissection, early transcranial Doppler sonography (TCD) primarily indicated the lesion. A subsequent carotid angiogram confirmed the diagnosis. The course of the disease was followed by daily TCD recordings and repeated SPECT measurements. Beside CT and angiography, TCD and SPECT are helpful guidelines for different therapeutic approaches aiming to reduce cerebral ischaemia and infarction

Keywords: CAROTID ARTERY DISSECTION/CT/SPECT/STROKE/TCD/TRANSCRANIAL DOPPLER SONOGRAPHY

Farman, C., Chen, Z.P., Branston, N. and Symon, L. (1994), The Effect of Hemodilution and Hypercapnia on the Recovery of Cerebral Function from Experimental Focal Ischemia. Acta Neurochirurgica, 127 (3-4), 210-214.

Abstract: The direct cortical response (DCR) and associated local cerebral blood flow was recorded from the primate cerebral cortex during a period of focal ischaemia induced by middle cerebral artery occlusion (MCAO). The DCR was lost when local blood flow fell below 20 ml/100 g/min but began to recover as collateral flow increased. Hypercapnia demonstrated a loss of local vascular reactivity following MCAO, but isovolaemic haemodilution still proved effective in increasing blood flow to these areas. The reduction in blood oxygen content induced by haemodilution did not impair cerebral function but the reduction in whole blood viscosity did exacerbate cerebral susceptibility to hypercapnia-induced intra-cerebral steal

Keywords: ARTERY OCCLUSION/BLOOD-FLOW/BRAIN/CEREBRAL BLOOD FLOW/CEREBRAL FUNCTION/CORTEX/HEMATOCRIT/HEMODILUTION/HEMORHEOLOGY/HYPERCAPNIA/INTRACEREBRAL STEAL/ISCHEMIA/ISOVOLEMIC HEMODILUTION/OXYGEN/STROKE

Morooka, H., Hirotsune, N., Wani, T. and Ohmoto, T. (1994), Histochemical-Demonstration of Free-Radicals (H2O2) in Ischemic Brain Edema and Protective Effects of Human Recombinant Superoxide-Dismutase on Ischemic Neuronal Damage. Acta Neurochirurgica, 307-309.

Abstract: A new histofluorescence method by HPAA (p-hydroxyphenyl acetic acid) for free radicals in the brain tissue was devised to study neuronal damage induced by ischemia. Cerebral ischemia was produced in rats by injection of plastic microspheres and arachidonic acid (AA) into the right carotid artery. The concentration of malondialdehyde (MDA; free radical) in cerebral cortex of aminotriazol (an H2O2-dependent inhibitor of catalase) treated rats 2 h after stroke was 6.33 times the level before infarction, while the concentration of MDA in h-r SOD (free radical-scavenging enzyme) treated rats 2 h after stroke was significantly lower than in untreated rats. The histochemical findings demonstrated marked H2O2 production around blood vessels occluded by microspheres in the cerebral cortex of the aminotriazole treated rats 2 h after stroke together with disruption of the BBB. Light microscopical findings demonstrated extensive edematous changes in the aminotriazole treated rats 2 h after stroke, while pathological damage in SOD treated rat brains was absent or minimal. We conclude that free radicals are formed during ischemia, and that AA appears to be a major source of activated oxygen radicals. The findings indicate that SOD is protective against ischemia-induced neuronal damage

Keywords: AMINO-ACID RELEASE/ARACHIDONIC-ACID/CEREBRAL ISCHEMIA/CITY/FREE RADICAL/HISTOCHEMISTRY/SUPEROXIDE DISMUTASE

Hellstrom, H.O., Wanhainen, A., Valtysson, J., Persson, L. and Hillered, L. (1994), Effect of Tirilazad Mesylate Given After Permanent Middle Cerebral-Artery Occlusion in Rat. Acta Neurochirurgica, 129 (3-4), 188-192.

Abstract: The effect of the antioxidant drug tirilazad mesylate (U- 74006F) on histopathological and neurological outcome 3 days after permanent middle cerebral artery (MCA) occlusion was evaluated in rats. Several previous studies have demonstrated the efficacy of tirilazad in reducing infarct size when administered before and during MCA occlusion, whereas post- treatment may be less effective in permanent focal ischaemia. We sought to determine if a protective effect of tirilazad could be demonstrated when administered after the insult only. U-74006F (3 mg/kg, i.v.) or sterile vehicle, was randomly given to rats 10 minutes and 3 hours after permanent MCA occlusion produced by transcranial proximal electrocauterization. Infarct volume and hemisphere volumes were estimated blindly from histological sections of defined levels of the brain after 72 h of ischaemia. Neurological score was determined blindly 1, 2, and 3 days after insult. There was no significant difference in infarct volume, volume of non-infarcted tissue, or neurological score between the tirilazad and placebo-treated rats. In conclusion, our results support the conception that post- treatment with tirilazad mesylate is not efficacious in reducing infarct size in permanent focal ischaemia, while pre- treatment, as reported by other groups, appears to be effective in both permanent and temporary focal ischaemia models. In temporary focal ischaemia, the limited data available suggest that also post-treatment with tirilazad may prove to be neuroprotective

Keywords: CEREBROSPINAL-FLUID/DAMAGE/FOCAL CEREBRAL ISCHEMIA/INFARCT SIZE/INFARCT VOLUME/ISCHEMIA/LAZAROID/LIPID-PEROXIDATION/MCA/MCA OCCLUSION/MODEL/NEUROPROTECTION/PATHOPHYSIOLOGY/RAT/STROKE/TIRILAZAD MESYLATE/U-74006F/U74006F

Valtysson, J., Hillered, L., Andine, P., Hagberg, H. and Persson, L. (1994), Neuropathological End-Points in Experimental Stroke Pharmacotherapy - the Importance of Both Early and Late Evaluation. Acta Neurochirurgica,
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